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The study presented an extremely rare case of real complete bilateral duplication of inferior vena cava (IVC) in a male cadaver which has never been reported before. Both IVC had approximately the same diameter. The right IVC drained into the right atrium; the left IVC continued as hemiazygos vein and drained into the superior vena cava. Three anastomotic venous channels, a cranial preaortic, a middle and a caudal retroaortic, joined both vessels. Multiple variations in the way of drainage of posterior intercostal veins, on both sides, were also present. The present report invalidates an old classification defining the two vessels when joined at the level of the renal veins as complete bilateral duplication of IVC. Although the presence of combination of venous variations is extremely rare, awareness of such variations is essential for clinical and surgical procedures to avoid misdiagnosis and surgical complications.

Sensitivity to pollution in Burullus Lake was estimated based on the proximity analysis. The category of sensitivity was based on six factors including: agricultural areas, industrial areas, drains...

Background The concepts of brain excitability are still re-wiring in response to changes in environment. Ambulation is often limited in stroke patients. Objective To determine the effect of cycling exercise on motor excitability and consequences on spatiotemporal gait parameters in stroke patients. Methods Forty male ischemic stroke patients were included; their age ranged from 45 to 60 years. The patients were assigned into two equal groups: control group (GI) and study group (GII). The GI is treated by a design physical therapy program in the form of task-oriented progressive resistance exercise for lower limb muscles, and the GII is treated by the same program in addition to cycling exercise for 30 min. Treatment was conducted three times per week for 10 weeks. The excitability over motor area (Cz) was assessed by the quantitative electroencephalogram (QEEG). The spatiotemporal gait parameters were assessed by the Biodex Gait Trainer 2TM. Results There was a significant increase of speed, step cycle, and step length of the affected side (P < 0.05) and a non-significant difference of step length of the non-affected side in the study group compared with that of the control group (P > 0.05). There was a significant increase of excitability over motor area (Cz) in the study group compared with that of the control group (P < 0.05). Conclusion Cycling exercise has a positive effect on excitability over motor area of lower limbs and can improve gait parameters in stroke patients.

Disposal and accumulation of agricultural and sanitary wastewater in poorly engineered ponds in the Mut region, Dakhla Oasis of Egypt is a concern due to their poor water quality; significant expan...

BACKGROUND: Cortical reorganization between both cerebral hemispheres plays an important role in regaining the affected upper extremity motor function post-stroke. OBJECTIVES: The purpose of the current study was to investigate the recommended number of contra-lesion low frequency repetitive transcranial magnetic stimulation (LF-rTMS) sessions that could enhance cortical reorganization post-stroke. METHODS: Forty patients with right hemiparetic subacute ischemic stroke with an age range between 50–65 yrs were randomly assigned into two equal groups: control (GA) and study (GB) groups. Both groups were treated with a selected physical therapy program for the upper limb. Sham and real contra-lesion LF-rTMS was conducted for both groups daily for two consecutive weeks. Sequential changes of cortical excitability were calculated by the end of each session. RESULTS: The significant enhancement in the cortical excitability was observed at the fourth session in favor of the study group (GB). Sequential rate of change in cortical excitability was significant for the first eight sessions. From the ninth session onwards, no difference could be detected between groups. CONCLUSION: The pattern of recovery after stroke is extensive and not all factors could be controlled. Application of LF-rTMS in conjugation with a selected physical therapy program for the upper limb from four to eight sessions seems to be efficient.

The present study was conducted at Sakha Agricultural Research Station's Experimental Farm to evaluate six wheat genotypes during 2017/18 and 2018/19 wheat growing seasons under normal irrigation (five irrigations) and reduced irrigation (only one irrigation after the establishment). A randomised complete block design with nine replicates was the experimental design. Two stress tolerance indices were calculated to differentiate the high yielder and water deficit tolerant wheat genotypes. Results showed that the irrigation effect was highly significant for all studied characters, except for number of kernels spike-1. The mean values of all studied characters in the normal irrigation were higher than those recorded in the reduced irrigation, except for number of kernels spike-1 and 1000-kernel weight. There were a highly significant differences among genotypes for all the studied characters. The best cultivar was Misr 2 which recorded the highest values for grain filling rate, number of spikes m-2 and grain yield with a significant differences compared to the other studied genotypes. Two susceptible/tolerance indices indicated that the three genotypes namely Cham 4, Sakha 93 and Vorobey were identified as stress tolerant genotypes and the genotypes Cham 4 had the higher grain yield as well. Accordingly, it was recommended to be used in wheat breeding programs to transmit tolerance genes to the commercial cultivars for reduced irrigation.

Hailey-Hailey disease (HHD), or familial benign chronic pemphigus, is a rare inherited acantholytic dermatosis. It is an autosomal dominant disease affecting the intertriginous areas. HHD has been characterized by flaccid blisters, erosions, and macerations that are limited to flexural (friction-prone) areas. The painful blisters and erosions significantly decrease patients’ quality of life. There are multiple types of therapy related to this disorder. Many of the studies have suggested benefits from steroid therapy in addition to oral antibiotics.

One of the important projects that the Egypt country seeks to implement is the desert areas development, which contributes significantly to agricultural and urban development. Development of desert areas, especially agricultural development, should be carried out scientifically in terms of the use of available water resources, irrigation methods according to the type of soil and taking the geo-environmental risks into consideration. The objective of this research is to assess the geo-environmental impact in the region under consideration and their effect on their natural components during their development phases. Estimating the rate of land-use/land-cover changes in the area is extremely important for the management of natural resources. Remote sensing and GIS techniques have been used to process the geological, topographical, land-use/land-cover and also locating high-risk areas that could be affected by flash flooding. This study showed that the study area comprises three land-cover classes: urban, agricultural and barren land. The expansion in the agricultural and residential areas was estimated from the Landsat satellite images from 1984 to 2018. The results had deduced the reasons for increasing the agricultural area and the validity of the western plateau lands for agricultural reclamation as well as land investment for residential projects such as Nasser city. The results indicate that the vegetated land increased by 9.68% and urban land by 3.17% after reclamation efforts were initiated.

Background: Multiple Sclerosis (MS) is a common, com-plex neurological disease. Balance Disorders (BDs) and ataxic symptoms are the most frequent and challenging symptoms in MS, lead to abnormal postural stability which have adversely effect on patients independence, participation and quality of life. Aim of Study: To investigate the effect of task oriented training exercises on balance in ataxic MS patients. Subjects and Methods: Thirty patients from both sexes diagnosed with remitting and Relapse Multiple Sclerosis (R.RMS) with ataxic symptoms and EDSS score ranged from 2 to 4.5, were recruited from multiple sclerosis specialized clinic in the Neurology Department, Faculty of Medicine, Cairo University and were randomly assigned into two equal groups. Results: In control group there is significant improvement in Stability Index (SI), Anterior Posterior Stability Index (APSI) and non-significant improvement of Mediolateral Stability Index (MLSI), and berg balance scale. In the study group there is a significant improvement in all balance meas-ures between pre and post treatment assessment. Study group results were highly significant than the control group (p

It is imperative for any traffic safety enhancing effort to collate and analyze detailed data about crashes. This article describes a study that investigated all aspects related to motor vehicle crashes resulting in human injuries or deaths in Riyadh. The database consisted of 295 collisions involving 331 vehicles, 596 fatalities (car passengers and pedestrians) and 2,454 injuries with Abbreviated Injury Scale (AIS) ≥ 1. Results show that only 15.1% of all vehicle occupants were wearing seatbelts at the time of collision which is reflected in having most injuries occurring to upper parts of the body and the spine. It is also reflected in a high incidence rate of 0.22 fatalities per crash. The average age of victims was 33 years with three quarters of them being males. Results also show that human actions, like reckless driving, over speeding, and sudden lane deviations were the causes of most collisions. It is concluded that in order to improve traffic safety conditions in Riyadh and in the whole country, a change in driving culture of all road users is needed. This can only come with improved awareness of the risks involved among road users, better law enforcement and other engineering and hi-tech countermeasures like smart red lights.

The study aims to identify the approaches to sustainable development and its relationship to governance mechanisms, through the definition of the concept of sustainable development in its general framework, as it is an integrated approach because of its integrated linkage, it combines economy, environment and society, Also, through the definition of governance mechanisms in that it is a system that identifies the elements that work together in a coherent and effective framework to protect and achieve the interests of the parties associated with the facilit. Accordingly, the practical aspect of the study was based on a sample of 10 industrial companies listed in the Egyptian Stock Exchange Index (S&P EGX ESG) for the period (2012 to 2018) through an applied study through analysis of the content of the reports and financial statements of the companies that were disclosed. Using descriptive statistical measures. Inferential statistical methods to test the relationship between study variables. The study variables consist of the dependent variable, "sustainable development" and the independent variable, "governance mechanisms". The study relied on which included seven variables, namely, "administrative ownership". The size of the Board of Directors, the number of times of the Board of Directors meeting, the independence of the Board of Directors, the size of the Audit Committee, the number of times of the Audit Committee, the independence of the Audit Committee. For sustainable in the companies under study, due to the fact that the disclosure of sustainable development practices, disclosure optional, as well as the lack of accounting standards governing the method of measurement and methods disclosed. The study concluded that there was a significant relationship between the independent variables and the dependent variable, including through the use of a gradual regression analysis model to identify the independent variables affecting the dependent variable, and through that was reached several results were able to overcome some of the problems encountered in achieving The hypotheses of the study model using statistical treatment through which two models were reached for the gradual regression, and by analyzing the variance and the estimated equation coefficients of the two models, the second model was chosen because of the large correlation coefficient and the estimation error is lower than the first model.

ObjectivesStudies have shown that acute kidney injury (AKI) occurrence post SARS-CoV-2 infection is complex and has a poor prognosis. Therefore, more studies are needed to understand the rate and the predications of AKI involvement among hospitalized COVID-19 patients and AKI’s impact on prognosis while under different types of medications.Patients and methodsThis study is a retrospective observational cohort study conducted at Bahrain Defence Force (BDF) Royal Medical Services. Medical records of COVID-19 patients admitted to BDF hospital, treated, and followed up from April 2020 to October 2020 were retrieved. Data were analyzed using univariate and multivariate logistic regression with covariate adjustment, and the odds ratio (OR) and 95% confidence (95% CI) interval were reported.ResultsAmong 353 patients admitted with COVID-19, 47.6% developed AKI. Overall, 51.8% of patients with AKI died compared to 2.2% of patients who did not develop AKI (p< 0.001 with OR 48.6 and 95% CI 17.2–136.9). Besides, deaths in patients classified with AKI staging were positively correlated and multivariate regression analysis revealed that moderate to severe hypoalbuminemia (ConclusionsThe incidence of AKI in hospitalized COVID-19 patients and the mortality rate among AKI patients were high and correlated with AKI staging. Furthermore, laboratory testing for serum albumin, hypercoagulability and cardiac injury markers maybe indicative for AKI development. Therefore, clinicians should be mandated to perform such tests on admission and follow-up in hospitalized patients.

Balance and ataxic symptoms are commonly encountered in people with multiple sclerosis (PwMS). Many intervention approaches have been proposed to address balance in PwMS. The purpose of this study was to investigate the efficacy of adding core stability versus task oriented trainings on traditional approaches on balance in ataxic PwMS.Forty five ataxic relapsing-remitting PwMS from both sexes were randomly assigned into three identical groups. Control group (CG) treated with conventional balance exercise program; study groups I (GI) and II (GII) received respectively additional training using core stability exercises and task oriented trainings. Outcome measures recorded pre and post study period included stability index (SI), anterior posterior stability index (APSI), and mediolateral stability index (MLSI) using Biodex stability system in addition to the Berg balance scale (BBS).Post treatment, the results indicated significant improvement in (SI) and (APSI) (p0.05), and non-significant improvement (p0.05) in (MLSI) and BBS in CG. In GI and GII there was a significant improvement in all balance measures (p0.05). Comparison of post treatment results between groups indicated a significant improvement of GII compared to CG in all study measures, GI showed non- significant difference in all balance measures compared to the CG(P0.05).In PwMS balance rehabilitation should be multimodal; core stability exercises and task-oriented training in addition to conventional balance training are effective to improve balance and should be considered as an essential part of the training program for balance rehabilitation in ataxic PwMS. Task-oriented training in addition to conventional balance rehabilitation seem to be a favorable approach.

We present a case of an intra-orbital, subperiosteal organizing hematoma (pseudocyst) which was referred to our clinic with a misdiagnosis of an orbital epidermoid cyst. This confounding lesion caused a great deal of debate following a magnetic resonance imaging (MRI) scan. It was only after surgery and investigating that the patient remembered an incident with orbital trauma nearly 2-years prior. We used existing literature to hypothesise that this lesion has a spectrum of presentations readily reported, but poorly presented. Histo-pathologically it seems feasible that this lesion progresses from an acute intra-orbital subperiosteal haemorrhage, to an organizing hematoma with associated scar tissue (pseudocyst) which would eventually develop into a chronic hematic (blood) cyst.

Context Hypertensive disorders complicating pregnancy are common and form one of the deadly triad, along with hemorrhage and infection that contribute greatly to maternal morbidity and mortality. Close antenatal care is considered the corner stone in early diagnosis of the disease and picking up of the severe cases with subsequent early management and intervention. On the other hand aggressive management of severe cases of high risk pregnancy is considered the second line of defense against maternal and preinatal morbidity and mortality. Objective The aim of this work is to assess the accuracy of middle cerebral artery and umbilical artery Doppler in predicting perinatal outcome in women with PIH in the third trimester. Methodology In this study which included 100 women with pregnancy induced hypertension who admitted to Ain Shams university maternity hospital our aim was to assess the accuracy of middle cerebral artery and umbilical artery Doppler in predicting perinatal outcome in women with PIH in the third trimester including predicting admission to NICU and the duration of treatment, low Apgar score at 5 minutes, Gestational age at delivery, fetal weight at birth and perinatal mortality. Results There was a significant association between MCA PI abnormalities and higher rates of NICU admission, 5-minutes Apgar score < 7, Low gestational age at delivery, Low birth weight and perinatal mortality. We found that the MCA PI for prediction of NICU admission was the best with (sensitivity 86.8 %, specificity 55.3 %, PPV 68.7%, NPV 78.8%).This was more predictive than either the UA-PI or the MCA/UA PI ratio. In our study, MCA PI was found to be a good predictor of poor neonatal outcome in patients with pregnancy induced hypertension especially in prediction of perinatal mortality and incidence of NICU admission. Conclusion Middle cerebral artery pulsatility index is more sensitive and more sensetive than umblical artery pulsatility index and middle cerebral arery/ umblical artery pulsitility index ratio in prediction of adverse perinatal outcomes. However middle cerebral arery / umblical artery pulsitility index ratio showed more specificity in predection of perinatal outcome in patients with pregnancy induced hypertension.

In this paper, a method combining the use of discrete shearlet transform (DST) and the gray-level co-occurrence matrix (GLCM) is presented to classify surface defects of hot-rolled steel strips into the six classes of rolled-in scale, patches, crazing, pitted surface, inclusion and scratches. Feature extraction involves the extraction of multi-directional shearlet features from each input image followed by GLCM calculations from all extracted sub-bands, from which a set of statistical features is extracted. The resultant high-dimensional feature vectors are then reduced using principal component analysis. A supervised support vector machine classifier is finally trained to classify the surface defects. The proposed feature set is compared against the Gabor, wavelets and the original GLCM in order to evaluate and validate its robustness. Experiments were conducted on a database of hot-rolled steel strips consisting of 1800 grayscale images whose defects exhibit high inter-class similarity as well as high intra-class appearance variations. Results indicate that the proposed DST–GLCM method is superior to other methods and achieves classification rates of 96.00%.

Background Burullus Lake has received a great attention because of its environmental and economic importance for being a significant source of fish production in Egypt. It is subjected to many of environmental changes due to the huge amount of discharges originated from different sources as well as many human activities. The Nile tilapia (Oreochromis niloticus) is an abundant sedentary fish present in the most Egyptian lakes, Nile River, and ponds. The study was designed to evaluate some metal pollution in Burullus Lake. Results The values of heavy metals (Mn, Zn, Fe, Ni, Cu, and Pb) were measured in lake water and muscles of O. niloticus fish during winter and summer 2014. Water samples were collected from six sampling sites, while fish samples were collected from the three sectors (eastern, middle, and western) of the lake. The mean values of heavy metals (Mn, Zn, Fe, Ni, Cu, and Pb) in surface water of Burullus Lake during winter and summer for the year 2014 were 1.09, 10.50, 29.38, 6.87, 2.05, and 5.98 μg/L, respectively, whereas the annual means of heavy metals (Mn, Zn, Fe, Ni, Cu, and Pb) in the muscles of O. niloticus fish were 0.68, 4.70, 10.62, 0.52, 0.39, and 0.46 μg/g wet wt., respectively. Conclusions In lake water, Mn was the lowest concentration of the six sampling sites, while Fe was the highest concentration, whereas in fish muscles, Cu recorded the lowest concentration of the three sectors, while Fe was the highest concentration. The southern part of Burullus Lake had the highest heavy metal values as it influenced by the discharge of massive amounts of domestic sewage as well as agricultural and industrial effluents. The accumulation of heavy metals in fish muscles of the three sectors showed different patterns. Generally, the values of metals in the fish muscles were accepted by the international legislation limits and are safe for human consumption.

Objectives It is not always easy to diagnose tuberculosis (TB) accurately; thus, there are always continuous trials to find the best possible method with a short duration and acceptable accuracy. This study aimed to correlate between serum adenosine deaminase (ADA) and cancer antigen 125 (CA125) in the assessment of severity of pulmonary TB. Patients and methods A total of 45 sex-matched and age-matched patients were included in our study and were classified into three groups: group I included 15 patients with active pulmonary TB with positive sputum smear result, group II included 15 patients with multidrug resistance pulmonary TB, and group III included 15 patients with pulmonary TB after sputum conversion. All included patients were subjected to detailed medical history; full clinical examination; chest radiography to determine the severity of the disease whether minimal, moderate, advanced, or far advanced; laboratory investigations [white blood cells count, platelet count, erythrocyte sedimentation rate (ESR), and sputum Ziehl–Neelsen staining]; grading on sputum smear microscopy as 1+, 2+, or 3+; sputum culture on L-J media; and CA125 and ADA analysis, where 5 ml of blood was collected and centrifuged and serum was separated, from which CA125 and ADA were measured using CA125II kits and ADA016 kits, respectively. Patients received antituberculous treatment in the hospital according to WHO and national guidelines. Results There was a significant statistical difference among the studied groups regarding CA125 and ADA, where P values were 0.018 and 0.014, respectively. Both were higher in group I measuring 64.42 U/ml and 24.22 U/l, respectively, and lower in group III measuring 27.22 U/ml and 16.08 U/l, respectively, after treatment for 2 months. In the current study, there was an insignificant statistical difference in serum CA125 and ADA regarding age and sex, but there were statistically significant differences among the studied groups regarding sputum Ziehl–Neelsen staining, chest radiography, and ESR. In this study, there was a significant positive correlation between both serum CA125 and serum ADA and chest radiography and ESR. Regarding sputum analysis, there was no difference regarding CA125 between positive and negative cases, but serum ADA was higher in positive cases than in negative ones. On the contrary, there was an insignificant statistical correlation between serum ADA and serum CA125.

This study carried-out in four successive summer seasons (2015 to 2018) at the experimental farm of the faculty of agriculture, Menoufia University, in Shebin El-Kom, Egypt. In 2015 season, S1 recurrent selection procedure was provied (Tep#5 and Gemmeiza yellow), where 200 S0 plants from each population were selfed to produce S1 progenies. In 2016 season, kernels of 100 S1 lines that selected from each two populations were separately sown for evaluation under two water regimes, i.e normal irrigation (NI) and drought stress conditions (DS). In 2017 season, the highest 10% of S1 progenies (10 S1 progenies of first Population (Tep#5) and 10 % S1 progenies of second Population (GMY) were planted for randomly mated by bulking pollen from the S1 plants. kernels harvested, four blends of seeds were obtained (Tep#5-NI, Tep#5-DS, GMY-NI and GMY-DS). In 2018 summer season, for each population the original cycle (C0) and the improved cycle (C1) were evaluated under normal irrigation (NI) and drought stress (DS). The results could be summarized as follows: Evaluate of 100 S1 progenies (Tep#5 and Gemmeiza yellow) for drought tolerance. Analysis of variance showed significant differences among the genotypes (S1 progenies) for all studied traits under both normal and drought stress conditions for two populations. A significant average reduction of 59.88% and 61.93% in grain yield/plot of the 100 S1’s for Tep#5 and Gemmeiza yellow respectively, due to drought stress. The superiority of the selected 10 S1’s over the 100 S1’s in grain yield was higher under drought stress than under normal conditions. Evaluation of the effectiveness of S1 recurrent selection of the two cycles for Tep#5 and Gemmeiza yellow populations under normal and drought conditions. One cycle of S1 recurrent selection using water-stress as a selection environment caused a significant actual improvement of grain yield of the newely developed populations (Tep#5-DS and GMY-DS) over its original populations (Tep#5 and GMY) of 15.47 and 12.78% under water stress condition. The improved populations Tep#5-NI and GMY-NI developed by using normal irrigation as a selection environment showed significant actual improvements in grain yield under normal irrigation (12.46 and 9.06%) environment. Both water stressed and non-stressed selection environments were efficient in improving grain yield under target environments. The two improved populations showed significant superiority in grain yield/fed over origin population under normal and drought stress conditions.

Background: Cervical spondylosis is a chronic degenera-tive condition of the cervical spine causing neck pain. Prop-rioception errors may be contributes to the development and maintenance of cervical spondylosis.Aim of Study: The study aimed to determine the proprio-ceptive reposition errors in cervical spondylosis patients.Patients and Methods: Twenty patients with cervical spondylosis (Group A) and twenty matched healthy subjects (Group B). Their age ranged 30-50 years old were represented the sample of the study. Cervical Range of Motion device (CROM) was used for assessment of proprioception error in flexion and extension. Results: There was significant reduction in absolute angular error of neck flexion, extension at neutral and target head reposition tests in Group B compared to Group A (p

Background Stroke results in an impaired sit to stand (STS) task. Pelvic movements are essential in daily living activities. Few studies investigated the effect of spine and pelvis separately on functional activities in stroke patients. Objective The study aimed to assess the angles of pelvic inclination (anterior and posterior pelvic tilt angles) (APT and PPT) during sitting position and during STS movement. It aimed also to determine the influence of sagittal pelvic tilt angles on STS performance in stroke patients. Patients and methods Thirty male hemi-paretic stroke patients (GI) and 15 matched healthy volunteer subjects (GII) represented the sample of this study. Stroke patients were assigned into two equal groups (group Ia and Ib). Sagittal pelvic tilt angles were measured by using the palpation meter inclinometer during sitting position and during initiation and mid of STS by using two dimensional (2D) video-based motion analysis system. Time of five repetitions STS test was used to assess the ability to perform STS task. Results The results showed a significant increase of PPT angle during static sitting, a significant decrease in APT angle during initiation and mid of STS task and a significant increase in time taken for five repetitions STS test in both stroke groups (P < 0.05). Conclusion Abnormal pelvic alignment and movements affect the functional performance of stroke patients during sitting and sit to stand task. Trial registration NCT03053154. Registered January 22, 2017. Retrospectively registered.

Digital fibromyxoma is a rare soft tissue tumor with a propensity to grow in the digits of the hands and feet. While mostly asymptomatic, the tumors can grow and cause discomfort and eventually pain. It is a benign tumor, with treatment revolving around complete excision to prevent recurrence. In this case report, we discuss the case of a 11-year old boy presented with a swelling in the right ring finger that had been increasing in size for over a year. Despite the lack of pain or limitation of movement in the finger, the swelling caused concern to the patient and family due to cosmetic appearance. An excision biopsy with histopathological analysis of the tissue sample suggested the diagnosis of digital fibromyxoma. The high rate of recurrence is due to incomplete excision, and therefore regular follow up is recommended to monitor for recurrence.

Heritability in type 2 diabetes mellitus (T2DM) is observed but not well understood.In this study, family history and clinical/biochemical data from 789 Bahrainis (418 T2DM, 371 controls) was analyzed. Fasting blood glucose (FBG) and HbA1c were measured and angiotensin-converting enzyme (ACE) and methylene tetrahydrofolate reductase (MTHFR) polymorphisms (SNPs) were analyzed.Patients compared to controls have higher proportions of diabetic mothers (50.2% vs. 32.7%, p=0.005), fathers (35.2% vs. 12.1%, p0.001) and siblings (56% vs. 15.3%, p0.001). The proportions of diabetic mothers was higher than the proportions of diabetic fathers among the patients (50.2% vs. 35.2%, p0.001) and the controls (32.7% vs. 12.1%, p0.001). Patients born to diabetic mothers compared to the other patients were smaller in age at the time of enrollment in this study (p=0.005), and at onset of T2DM (p0.001), and also had higher FBG (p=0.033). Interestingly, the prevalence of T1DM was highest amongst the siblings of the controls compared to patients (p=0.04). Finally, the heterozygote I/D genotype of the ACE gene was over expressed in patients born to diabetic mothers when compared to patients born to diabetic fathers, p=0.007.there was strong clustering of T2DM in families, with significant dominant maternal role in transmission of T2DM and associated severity markers. Patients (T2DM) born to diabetic mothers were genetically and phenotypically different from the other patients.

Background Chronic shoulder pain following cerebrovascular stroke (CVS) is a major problem that persists after maximum recovery of motor functions. Such pain has been attributed to altered shoulder joint kinematics causing soft tissue damage. Aim Evaluation of shoulder proprioception in the ipsilateral paretic arm and contralateral unaffected side 6 months following cerebrovascular event. Subject and method Thirty adult patients (G1) with ischemic strokes ranging from 6 months to 1 year and 30 healthy control (G2) were assessed for shoulder proprioception. Angular displacement error was measured during active and passive repositioning of shoulder external and internal rotation in both patients’ shoulders and in control’s dominant upper limb. Results Statistically significant increase in angular displacement error was found in all tests in the affected shoulder compared to the unaffected contralateral shoulder and dominant arm of control subjects. The contralateral unaffected shoulder of patients showed within normal values and no differences with control values. Passive external and internal rotations showed statistically higher errors in patients with cortical lesions compared to those with subcortical lesions. Conclusion Six months following the CVS, shoulder proprioception deficit in the affected hemiparetic side persists. Contralateral side shows no abnormalities. Cortical lesions might be associated with late shoulder proprioception recovery compared to subcortical lesions. The side of the lesion does not seem to affect the severity of proprioception deficit.

Purpose The purpose of this study was to conduct a matched-pair analysis to determine the effect of prior lumbar spine surgery (LSS) on clinical outcomes of hip arthroscopy. Methods Data were prospectively collected on all patients undergoing hip arthroscopy during the study period from April 2008 to December 2012. Patients were excluded if they had previous hip conditions or had undergone prior hip surgery. Patients in the LSS group (history of LSS) were matched in a 1:1 ratio to a control group (no history of LSS) according to age ±5 years, gender, body mass index categories, Tonnis grade, and labral treatment. The following outcomes were recorded in each group: modified Harris Hip Score, Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Sports Specific Subscale, Hip Outcome Score–Activities of Daily Living, and visual analogue scale (VAS) score for pain, patient satisfaction, and rates for revision hip arthroscopies and conversion to total hip arthroplasty (THA). Results During the study period, 1,405 hip arthroscopies were performed with 1,017 eligible for matching. A total of 873 (85.8%) patients had a minimum 2-year follow-up. Fifty-seven patients were matched in each group. Both groups demonstrated significant improvement in patient-reported outcome (PRO) and VAS scores. The LSS group had a lower mean for all preoperative PRO scores. There was no significant difference for the postoperative mean PRO score and change in the PRO score compared with the control group except for NAHS. The mean change in the NAHS demonstrated a greater magnitude of improvement in the LSS group. There was no significant difference between mean VAS scores, patient satisfaction, and rates for revision arthroscopy and conversion to THA between the groups. Conclusions Prior LSS does not adversely affect outcomes of hip arthroscopy at a minimum 2-year follow-up. These patients have lower preoperative scores but similar magnitude of improvement and revision/THA rates compared with a matched comparative group of patients without prior LSS. Level of Evidence Level II, retrospective analysis of prospectively collected data.

One of the best methods for diagnosing bone disease in humans is site-specific and total bone mineral density (BMD) measurements by Dual-energy X-ray Absorptiometry (DXA) machines. The basic disadvantage of this technology is inconsistent BMD measurements among different DXA machines from different manufacturers due to different image analysis algorithms. The objective of the present study was to apply artificial neural networks (ANNs) to estimate total BMD for diagnosing a population of Egyptians with and without pathology, using extracted features from DXA-DICOM images based on the Histogram and Binary algorithms as compared to reference BMD measurements by DXA machine. The sample size comprised 3000 male and female participants with an age range 22-49 years, who were referred to us for diagnosis and/or treatment and for DXA total body scans in the period from January 2016 till December 2017. We constructed an entry computer data-logging visible unit, where we applied morphological operations to get a specific bone image, and used their extracted feature vectors as inputs to ANNs with cascade training, gathering, and testing for DXA-DICOM image processing. The multilayer feed-forward ANN set up its initial weights, carried out training and initiated the recall mode, and finally observed its decision and interaction based on estimated BMD. The ANN construction was carried out using a 3-layer architecture, with one hidden layer of 85 neurons. The input layer has neuron numbers equal to 256 for the Histogram and 77,365 for Binary algorithms, respectively. Total BMD estimation performance based on the Binary algorithm was capable of identifying all DXA-DICOM images with an accuracy of 100% for the training, cross-validation, and testing of the ANN phases. We believe this strategy will represent the means for standardizing bone measurements of all DXA machines, regardless of the manufacturer.

Identifying the specific machining processes used to produce specific workpiece surfaces is very useful in materials inspection. Machine vision can be used to semi- or fully automate this identification process by firstly extracting features from captured workpiece images, followed by analysis using machine learning algorithms. This enables inspection to be performed more reliably with minimal human intervention. In this paper, three visual texture features are investigated to classify machined workpiece surfaces into the six machining process classes of Turning, Grinding, Horizontal Milling, Vertical Milling, Lapping, and Shaping. These are the multi-directional Gabor filtered images, intensity histogram and edge features statistics. Support Vector Machines (SVM) applying different kernel functions are investigated for best classifier performance. Results indicate that the Gabor-based SVM-linear kernel provides superior performance.

Improve the performance of the guidance process of topics that have attracted the attention of researchers in the past decades. One way in which the implementation of this improvement is to modify the guidance law. Where is replaced a fixed gain with a variable gain and employing the genetic algorithm to measure the performance of several forms of variable gain even get the minimum miss distance. This method has proved its efficiency and best results to achieve an interception between the pursuit and the evader with less error despite the change of range and direction and maneuver, and even in the case of a delayed line-of-sight rate. Also in this paper, a mechanical simulator, called Stewart platform, has been added to the pursuit-evader model. The microcontroller of the platform receives a serial data from the navigation system. The received data are converted into voltages and sent to the motors of Stewart platform to simulate proportional movements in six-degrees-of-freedom.

Lung cancer (LC) incidence represents 11.5% of all new cancers, resulting in 1.72 million deaths worldwide in 2015. With the aim to investigate the capability of the electronic nose (e-nose) technology for detecting and differentiating complex mixtures of volatile organic compounds in biofluids ex-vivo, we enrolled 50 patients with suspected LC and 50 matching controls. Tissue biopsy was taken from suspicious lung mass for histopathological evaluation and blood, exhaled breath, and urine samples were collected from all participants and qualitatively processed using e-nose. Odor-print patterns were further analysed using the principal component analysis (PCA) and artificial neural network (ANN) analysis. Adenocarcinoma, non-small cell LC and squamous cell carcinoma were the predominant pathological types among LC patients. PCA cluster-plots showed a clear distinction between LC patients and controls for all biological samples; where the overall success ratios of classification for principal components #1 and #2 were: 95.46, 82.01, and 91.66% for blood, breath and urine samples, respectively. Moreover, ANN showed a better discrimination between LC patients and controls with success ratios of 95.74, 91.67 and 100% for blood, breath and urine samples, respectively. The e-nose is an easy noninvasive tool, capable of identifying LC patients from controls with great precision.

Experiments and finite element analysis (FEA) were performed on scarf-patch repaired composite panels. Tensile static tests were performed on pristine and repaired panels to evaluate their tensile strength. The obtained results showed that the repaired panels restored tensile strength by 95% of the pristine value. Subsequently, a verification finite element (FE) model was established. Two additional models, one with homogenized mechanical properties of the laminate and one that considered that the ply-by-ply properties were built to simulate the experimental repairs. The predictions of the two models agreed reasonably well with the experimental results and the optimum scarf angle was found at 2.5°.

Background: The efficacy of an extract from date seeds has been tested successfully on the glycemic control of type I diabetes mellitus in rats. A suggestion that date seed extract could stimulate certain cells to differentiate into insulin-secreting cells has been proposed. In order to investigate such a possibility, this study was conducted to measure C-peptide levels in the serum of type 1 diabetic rats treated with date seed extract.Methods: Two hundred rats were divided into 4 groups. Group I served as the control. Group II was given daily ingestions of 10 ml of date seed extract. Groups III and IV were made diabetic by streptozotocin injection and were given daily subcutaneous injections of 3 IU/day of insulin for 8 weeks. Group IV received, in addition, daily ingestions of 10 ml of seed extract. At the end of experiment, blood samples were collected from each rat, and blood glucose and serum C-peptide levels were measured.Results: No significant differences in the means of blood glucose and serum C-peptide levels were observed between groups I (control group) and II (date seed extract-treated control group). Group IV (date seed extract-insulin-treated diabetic group) showed a statistically significant reduction in the mean blood glucose level compared to Group III (insulin-treated diabetic group). The mean serum C-peptide level was significantly higher in group IV compared to group III.Conclusion: Biochemical results suggested an increase in endogenous insulin secretion in the case of type 1 diabetic rats treated with date seed extract, which might be the cause of its hypoglycemic effect.Keywords: Date seed extract; type 1 diabetes; serum C-peptide

This paper presents shape optimization of lower control arm considering multi-disciplinary (stiffness, strength and durability) constraint conditions. As non-linearity of strength and durability is large out of the design constraint conditions and performance indexes are defined as min-max values, sensitivity is not reflected and instead, a sequential approximate optimization (SAO) method using a meta-model is suggested. In order to verify the efficiency of the suggested design method, shape optimization design of a 1 piece-typed lower control arm for compact cars is conducted. The design target aims to meet the multi-disciplinary (stiffness, strength and durability) design constraint conditions and at the same time, intends to minimize the weight. Design variables are 3 shape vectors and 1 thickness while design constraint conditions include 2 stiffness, 12 strength and 26 durability variables, featuring a big design problem. As a result, the design problem is solved in total 3 interation and the optimal model meets all of the design constraint conditions and reduces the weight by about 200 grams comparing with that of the initial model. Thus, the suggested design method is an appropriate method suitable for shape optimization design.

We report a simple, generally applicable, and noninvasive fluorescent method for mapping thermal fluctuations in hydrogel matrices using an unmodified commercially available digital single-lens reflex camera (DSLR). The nanothermometer is based on the complexation of short conjugated polyelectrolytes, poly(phenylene ethynylene) carboxylate, with an amphiphilic polymer, polyvinylpyrrolidone, which is in turn trapped within the porous network of a gel matrix. Changes in the temperature lead to a fluorescent ratiometric response with a maximum relative sensitivity of 2.0% and 1.9% at 45.0 °C for 0.5% agarose and agar, respectively. The response was reversible with no observed hysteresis when samples were cycled between 20 and 40 °C. As a proof of concept, the change in fluorescent signal/color was captured using a digital camera. The images were then dissected into their red-green-blue (RGB) components using a Matlab routine. A linear correlation was observed between the hydrogel temperature and the green and blue intensity channels. The reported sensor has the potential to provide a wealth of information when thermal fluctuations mapped in soft gels matrices are correlated with chemical or physical processes.

This research investigates the in-plane stress concentration factor (SCF) in countersunk rivet holes in orthotropic laminated plates under uniaxial tension load. Finite element analysis (FEA) using ANSYS software is used to build and mesh the geometry of a plate containing a countersunk hole, define the boundary and loading conditions, run the analysis and obtain the SCF results. The effect of several geometric and material parameters such as plate thickness, straight-shank radius, countersunk angle, countersunk depth, plate width, and the laminate ply angles on the SCF is also investigated. Finally, multi parameter fit and factorial analyses are applied to establish the relationships between the SCF and the various geometric and material parameters, and to formulate a general equation for the SCF. Based on the results, it is found that the values of the SCF obtained by means of the formulated equation are within 7% of the finite element (FE) results for 96% of the runs and that the maximum overall error is less than 14%.

This paper was prepared to be acquainted with the effect of parasitic elements on the faulty antenna performance with respect to the performance of healthy antenna without directors. This work interested in two models of microstip antennas, the first consists of four elements without directors and the second is an antenna with three directors as parasitic elements. The antenna was designed and simulated using HFSS to be suitable for the antenna parameters determination such as maximum radiation intensity, directivity, gain, radiation pattern, and return loss. Monitoring and analysis of the results was done comparatively between the two models, where the two models of antennas are working in normal conditions (healthy case) and faulty conditions as a discontinuity in the feeding line (On/Off fault) for one, two and three elements. The comparative study focuses on maximum radiation intensity, directivity, and gain values where model (1) gives ranges of 0.29 to 0.08 for maximum radiation intensity, 4.40 to 1.86 for directivity, 4.02 to 1.67 for gain; while model (2) gives ranges of 0.33 to 0.09 for maximum radiation intensity, 5.01 to 2.09 for directivity, 4.59 to 1.89 for gain. The results indicated that the presents of parasitic elements is beneficial for the performance of microstrip array antenna even it works in faulty conditions.

The main objective of this paper is to identify any current and future bottlenecks in the production system while honoring operational constraints on wells, production separators, pipelines, and total field gas/liquid processing capacity. It also concerns with identifying any flow assurance issues taking in consideration different field development scenarios for an offshore gas condensate field in the Mediterranean (Abu Qir Field). Liquid loading in gas wells occur when the gas flow rate falls below a critical rate due to reservoir depletion where the accompanying liquids cannot be lifted to surface. Such liquid accumulations at the wellbore can cause the gas well to cease production eventually. Severe slug flow (i.e., terrain-dominated slug flow) was studied. Severe slug flow is characterized by extremely long liquid slugs generated at the base of the vertical riser. This phenomenon occurs at low gas and liquid flow rates and for negative pipeline inclinations. To evaluate future development options and to provide a monitoring tool and realistic results, a multi-disciplinary Petroleum Engineering study was carried out. Unknown reservoir parameters were estimated using the modern production data analysis method, which was also used as a reliable forecasting tool. Steady state multiphase flow simulator and the forecast from production data analysis and numerical reservoir simulator were used to identify any current and future bottlenecks and also optimize the production taking in considerations field's constraints. Transient multiphase flow simulator was used to identify and mitigate transient flow assurance issues i.e. liquid loading in gas wells and slugs in the pipelines. Other scenarios were also studied include: platform start-up and shutdown; production Ramp up due to the introduced platform; and Hydrates no show time due to any shutdown. This helped us to determine the proper design envelope of the new system. This integrated workflow helped in optimizing the current operating conditions and decreasing field operating cost by increasing the current gas production rate by 6%. We managed to prevent the decline in reserves by more than 10% in the future caused by production system bottlenecks. Choke size for each well was identified honoring existing constrains (reservoir pressure, flow velocity limits, etc.) to increase field gas production. Outlet pressure of a surface network was maximized in order to minimize operational costs of gas processing while maintaining required gas production level. Different scenarios were carried out to come with procedures to prevent and mitigate production instabilities and also decreasing the deferred production. This work can subsequently propose an integrated field management workflow on addressing various production issues especially in case of limited data availability and how different domains can co-operate to reach the optimum operating scenarios.

BACKGROUND: Screw fixation of syndesmotic injuries facilitates ligament healing and restoration of ankle stability, but little information regarding screw performance is available. This study quantified the reduction obtained with three common 2-screw configurations using different methods of reduction and novel methods of subsequently provoking and measuring diastasis. METHODS: Seven fresh-frozen lower extremities were subjected to 100 N medial and lateral tibia loads with the talus restrained. Tibia displacement, indicative of ankle clear space, was recorded. The syndesmosis and distal interosseous ligament were disrupted and measurements repeated. A pressure sensor was inserted into the syndesmosis and three 2-screw fixation methods were evaluated in each specimen: 3.5-mm screws engaging both fibula cortices and the lateral tibial cortex, inserted while using a clamp to achieve syndesmosis reduction; 3.5-mm lag screws engaging both tibia cortices; and 4.5-mm lag screws engaging both tibia cortices. One thousand 100 N medial and lateral loads were applied and clear space and syndesmosis compression were quantified every 100 cycles. RESULTS: Normal ankle clear space averaged 1.98 mm and increased to 3.02 mm after syndesmosis disruption. Fixation decreased the clear space to 1.36 mm, 1.22 mm, and 1.19 mm for the 3.5-mm tricortical, 3.5-mm lag, and 4.5-mm lag screws, respectively, remaining steady throughout cyclic loading. Syndesmosis compression dropped markedly from 61N to 23 N on clamp release after tricortical screw insertion. The 3.5-mm and 4.5-mm lag screws exerted 112 N and 131 N, respectively, after insertion, and maintained compression several-fold greater than the tricortical screws during cyclic loading. No difference was demonstrable between the two lag screw sizes. CONCLUSION: While all screw configurations successfully reduced ankle clear space, syndesmosis reduction was more effectively maintained by lag screws than by tricortical screws inserted with clamp reduction. The transient nature of compression achieved by the reduction clamp suggests that use of lag screws for this application may more reliably maintain syndesmosis reduction in vivo. CLINICAL RELEVANCE: Optimizing reduction of syndesmosis injuries is critical for favorable outcomes. This study offers concrete information on screw performance in this application.

Context : Impairment of initiating sequential movements and processing of proprioception contribute to characteristic Parkinson's disease (PD) gait abnormalities. Many studies have used a single external cue or 2 different cues to correct PD gait. Aim: An aim of this study was to determine the influence of paired proprioceptive cues on gait parameters of individuals with PD. Setting and Design: Double-blind randomized controlled trial. Materials and Methods: Subjects were 30 PD patients who had mild to moderate impairment according to the United Parkinson's Disease Rating Scale (UPDRS). They were randomly assigned to either a routine physiotherapy program or treadmill training with vibratory stimuli applied to the feet plantar surfaces and proprioceptive neuromuscular facilitation (PNF) as well as the same physiotherapy program. All Participants received a 45-minutes session of low intensity physiotherapy program, 3 times a week, for 8 weeks. The duration of treadmill training was 5 minutes at baseline and 25 minutes at the end of treatment. Walking speed and distance were recorded from the treadmill control panel for both groups before and immediately after the end of treatment. The Qualysis ProReflex motion analysis system was used to measure cadence, stride length, hip, knee, and ankle joints' angular excursion. Results: The cadence, stride length, and lower limb joints' angular excursion showed a significant improvement in both groups ( P ≤ 0.05). These improvements in spatio-temporal parameters and angular excursion were higher in the study group than in the control group ( P ≤ 0.05). Conclusion: Potentiated proprioceptive feedback improves parkinsonian gait kinematics, the hip, knee, and ankle joints' angular excursion.

Objective: The aim of the present work is to study the protective effect of some antioxidants and trace elements against the hazardous effects of carbon tetrachloride (CCl4) on hamsters for the possibility of further application on humans. Methods: One hundred twenty hamsters weighing 104-128g were divided into 13 groups as follows: 1-Negative Control group fed standard diet, 2-positive control group given carbon tetrachloride (CCl4 ) only , 3-CCl4 + zinc, 4 - CCl4 + β-carotene,5- CCl4 + α-tocopherol,6- CCl4 + selenium, 7-CCl4 + vitamin C,8- CCl4 + zinc + β - carotene, 9-CCl4 + zinc + vitamin C , 10-CCl4 + zinc + α-tocopheral,11-CCl4 + selenium + β-carotene, 12-CCl4 + selenium + vitamin C and 13-CCl4 + selenium + α-tocopheral. Results: Carbon tetrachloride (CCl4) has a direct toxic effect on liver and kidney. Depending on biochemical results, the more antioxidants of liver protection against CCl4 toxicity are α tocopherol, followed by selenium, selenium + β - carotene, vitamin C, zinc + β – carotene and selenium + α tocopherol. The more antioxidant for kidney protection against CCl4 toxicity is β –carotene followed by selenium, zinc + β – carotene, zinc + α tocopherol, and zinc + vitamin C. Conclusion: Trace elements should not be given individually especially zinc or selenium as deleterious effects, in spite of its protective effect.

Abu Qir Petroleum Company (AQP) is one of the most important gas operators In Egypt. AQP Holds 100% of the exploration, development and production rights of the Abu Qir concession in the Nile Delta offshore. The offshore facilities include six platforms, 34 wells and a network of sea pipelines. Abu Qir Petroleum Company currently is interested in modeling their entire production system from the perforations to the onshore Facility to understand and identify all constraints in the system and the way to improve it. In addition, AQP is interested in identifying any bottlenecks either currently or in the future after adding any platforms or wells according to their intended FDP and to test some operational scenarios like changing terminal pressure, separator pressure, installing compression station, etc. The main objective of this project is to identify any current and future bottlenecks in the production system while honoring operational constraints on wells, production separators, pipelines, and total field gas/liquid processing capacity and identifying any flow assurance issues taking into consideration different field development scenarios for an offshore gas condensate field in the Mediterranean (Abu Qir Field). In many mature gas fields, reservoir pressure decline as a result of gas depletion tends to lead to the onset of liquid loading. Liquid loading in gas wells occur when the gas flow rate falls below a critical rate due to reservoir depletion where the accompanying liquids cannot be lifted to surface. Such liquid accumulations at the wellbore can cause the gas well to cease production eventually. Transient simulation was used to build transient well models that replicate observed field data, and these models are then used to evaluate specific gas well deliquification techniques. This document summarizes the methodology and the results of the complementary work carried out to conduct the project. The document presents the methodology to review, evaluate and optimize the offshore production system from reservoir sand-face up to wellhead starting from data gathering and QC up to estimating the missing reservoir parameters needed for well history matching ending with history matched well models and surface network ready for any optimization if the conditions change.

This paper presents an experimental evaluation of the defective patch repairs of solid laminated composites. The study uses both destructive and nondestructive tests on full-scale repaired panels to evaluate the repair performance under static tension loading conditions. While most reported studies use small coupon specimens, this paper presents test results of full-scale panels that allow strain field monitoring around the patch. The experimental results presented in this paper are the baseline for more advanced study to evaluate the performance of defective repairs in severe loading conditions (fatigue) that is underway by the authors. The nondestructive tests are performed by Iowa State University while the destructive tests are performed by North Carolina A&T State University. The testing program consists of 14 panels of six-ply (300 mm 675 mm) ((60/60/0)s) quasi-isotropic laminates: three pristine (undamaged parent material panels), three damaged panels without repair, three good repairs, three defective repairs due to inserted engineered flaw, and two repairs with mismatched fiber orientation. Two types of defective repairs are investigated: inserting 1-in. circular disbond between the sixth ply and the parent material forms the first type while the second type is formed by fiber mismatching between the patch and the parent material. Based on the evaluation performed in this study, the restored tensile strength of both defective and good repairs is within 80% of the strength of the pristine panels.

Background and Objectives: Pain estimation remains a difficult medical problem. Many subjective and objective methods were tried. Subjective methods depend on personal difference to a good extent and cannot be accurate. The aim of this work was to evaluate the validity of using electrical stimulation (ES) as an objective and valid method in quantitating the pain intensity and, consequently, the intensity of needed treatment. Methods: Twenty chronic low back pain (LBP) patients with sciatica and 20 normal subjects participated, and they were compared in this study. Electrical threshold and pain tolerance were recorded from the most painful site in the study group and from the corresponding matching site in the control group. Blood analysis for β-endorphin was done to objectively determine the intensity of pain as well as the objectivity and validity of ES in the assessment of pain. Pain intensity was also recorded by the visual analogue scale for each subject. Results: Significant differences between both groups regarding the threshold and pain tolerance to electrical current were noted. A significant positive correlation was also observed between β-endorphin level as well as the threshold and pain tolerance intensity in the patient group. Non-significant correlation was also observed between the visual analogue scale and β-endorphin level. Conclusion: ES is an objective and valid method, whereas visual analogue scale is a subjective method in the assessment of pain intensity in chronic LBP patients.

Introduction: The use of outcome assessment scales in scientific studies is necessary so that different treatment forms can be compared among individuals with the same diagnosis. Objectives: This study targeted the translation and validation of the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale into Arabic. Materials and methods: The scale was applied to 93 patients with ankle-hindfoot joint conditions. The patients were also assessed using the SF-36 (Short Form questionnaire-36 items) quality-of-life generic questionnaire and the visual analogue scale (VAS). Results: Pearson’ s correlation coefficient (PCC) was 0.77 (P

Background To evaluate and compare differences in the molecular genetics among high-risk (Ashkenazi Jews), intermediate-risk (Sephardic Jews) and low-risk (Palestinians) groups for colorectal cancer who live in the same geographical region. Patients and methods The 1995–1996 records from the Tel Aviv Medical Center and Muqased hospital (East Jerusalem) randomly identified patients with colorectal cancer. There were 25 patients from each ethnic group. Epidemiological data were obtained from interviews with the patients and from their hospital charts. The levels of cyclin D1, β-catenine, p27, p53, Ki-67 and Her-2/neu proteins were determined by immunohistochemistry. The main outcome measures were the association between gene expression and colorectal incidence in the different ethnic groups. Results Ashkenazi Jews have the highest rate of colorectal cancer, and are diagnosed at an early stage compared with Palestinians (72% and 33% of the cases are in Dukes’ A and B, respectively), and, hence, this may explain the better 5-year survival rate among this group. Sephardic Jews are diagnosed at a more advanced stage, the tumors are poorly differentiated and they lack p27. Palestinians have significantly higher cyclin D1 levels. There was a statistically significant inverse correlation between the expression of β-catenine and cyclin D1, as well as p53 and p27 (P Conclusions Increased expression of cyclin D1, p53, Ki-67, β-catenine and Her-2/neu, and decreased expression of p27 may be important events in the three ethnic groups with colorectal cancer. The lower mortality rate among Ashkenazi Jews may be partially explained by their better molecular biology profile.